Students must have acquired general medical practice equipment like: examining torch, to test the light effect on response of the eye pupil's, patella hammer, stethosco’e, pocket BP machine, and a sensation pin.

Students should know the patient's illness information and record such information in patients case note file. They are also required to follow up laboratory investigation results. Students should be able to make a probable diagnosis by the end of the clerkship of the patient, hence present the disease condition at hand to the supervising surgeon, as well as presenting the final diagnosis of the patient, and suggest the type of surgical treatment for the patient under examination. This is termed as presentation of the patient.

There shall also be discussion in the presence of other students. This is termed as bedside teaching. The hospital wards are the students’ hunting zones. There is no time limit for students’ stay in the wards.

Surgical practice follows under three categories:
1. Out patient (Clinics) attending to patients.
2. Patient care in the ward:
- Preparative period before operation.
- Post operative period after operation.
3. Operative care in the theatre.

Additional areas of practice are at the X-ray session demonstrations; and attending general seminars of surgical interest. There shall be select- lectures, usually in the AFTERNOONS, depending on available time.

Evaluation:
Evaluation of the practice will be valued as you put your theoretical taught methods of examining a patient ending with an acceptable most probable diagnosis. The grading will be reflected by marks scored on your clerkship presented case notes of the patient. In small hospitals patients with surgical conditions are few. You are however expected to have attended at least eight patients of each surgical disease listed at the end of your record book.

The booklet offered to the student is a guideline to ease their work in the surgical practice in the hospital wards. It is the introduction to operative surgery: it is by no means the end of practice in surgery ahead.

Clinical sessions in Paediatric Surgery.
- Paediatric trauma and burns in children.
- Congenital anomalies, septic conditions and tumours in children.

Guidelines to Students Assessment and Grading

Case Presentation (Style, Content)
i. Is the history reasonably precise, problem oriented, and clearly presented?
ii. Is the examination meticulous and can the student discuss and/or demonstrate the findings?
iii. Is the student able to suggest a reasonable diagnosis, differential diagnosis and relevant investigations?
iv. Can the student discuss a satisfactory plan of management and discuss the prognosis?
v. Has the student shown ability beyond what is expected of him/her?

Operations/Procedures
i. Is the student familiar with the patient being operated on. And present a clinical summary and preoperative work-up? Lactoratory (inicroseopic, biochemical) values, radiology ECG Euto etc.
ii. Does the student have sufficient knowledge of surgical anatomy and the operative procedure?
iii. Is the student conversant with the instruments, materials, and sutures being used?
iv. Is he/she able to discuss the postoperative management and suggest possible postoperative complications of the procedure?
v. Has the student shown extra-ability of what is expected of him/her?

GRADES:
Grade each case assessed separately on (1) - (5) above
A: = All the 5 criteria met.
B: = Only one out of the 5 criteria missed.
C: = Only two of the five criteria missed.
D: = Three are missed.
E: = Satisfactory on only one or none.


                      OUT- PATIENT CLINIC

Junior Clerkship Sopd   Cases	15
Senior   Clerkship 8 Sopd Cases	20
Emergency Casualty Admissions
Junior Clerkship	20
Senior Clerkship
Major Operation
(A) Cases (Patients) Examined And Their Diagnoses
Junior Clerkship Cases	20
Major Operation
(B) Surgical Names Of Operations Actually Attended By Student
Junior Clerkship Cases	12
Senior Clerkship	8
Minor Operations   Junior Clerkship	15
Minor Operations   Senior Clerkship	11

Key: Grades:

• A:      Excellent               5 Points.
• B:      Very Good             4 Points.
• C:      Good                   3 Points.
• D:      Fair                     2 Points.
• E:      Poor                   1 Point.

OTHER   COMMENTS	JUNIOR   CLERKSHIP	SENIOR   CLEARKSHIP
1. Attendance/Punctuality
2. Initiative/Interest
3. Discipline/Cooperation
4. Attitude to patients
5. Capacity for Extra work

KEY:

• JUNIOR CLERKSHIP             X/5
• SENIOR CLERKSHIP             X/25

21 Clinical sessions in General surgery

Sn	Items
1	Burns   in adults.
2	Goitre.
3	Breast   Lump.
4	Dysphagia/Carcinoma   of the oesophagus.
5	Peptic   ulcer disease.
6	Carcinoma   of the stomach.
7	Abdominal   mass.
8	Inguino-scrotal   swelling.
9	Obstructive   jaundice.
10	Colorectal   carcinoma.
11	Empyema.
12	Benign   Prostatic hypertrophy/carcinoma of prostate.
13	Carcinoma   of the urinary bladder.
14	Renal   mass.
15	Urethral   stricture.
16	Skinulcers/tumours/Pyomyositis/absecess.
17	Gastrointestinal   bleeding.
18	Acute   abdomen/Appendicitis/Appendicular mass.
19	Ano-rectal   conditions.
20	Gangrene/ischaemia.
21	Abdominal   trauma.

Clinical sessions in Paediatric Surgery.

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